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'A°F'"'x, " <br /> CITY(,E C "INSTRUCTION <br /> everett PERMIT PERMIT NO. 21246 <br /> 259-8745 <br /> ❑ DEMOLITION ❑ COMBINATION 9j BUILDING ❑ MECHANICAL U PLUMBING I 1 SIGN <br /> OWN)L MAIL ADDRESS CITY IIP PHONE <br /> Kohkoku USA, Inc. 1407 80th St. Everett 98203 353-7000 <br /> A3n� ARCIaTECT On DESIGNED MAIL ADDRESS CITY zip PHONE <br /> O[NERAI CONTRACTOR MNL ADDRESS CITY ZIP RHONE LICENSE. <br /> J! H Owner <br /> VY H (A M ECHANICAL CONTRACTOR MAIL ADDRESS CITY IIP MIMIE LICENSE. <br /> Fy4 PLUMBINGCONTRACTO1 MNL ADDRESS CITY !IP RHONE LICENSE. <br /> H y H CCAs Or MIRK <br /> NEW ❑ ADDITION ❑ ALTERATION El REPAIR O DEMOLITION ❑ BUILDING RELOCATION <br /> z VALUATION OF WORK <br /> 0 o S 134,400.00 _ <br /> O HH C DESCRIBE WORK <br /> F^ro+ tcn O Frame Building <br /> y,V EJ <br /> HEAT SOURCE <br /> "L H y ❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑OTHER <br /> PROPOSED LISE OF BUILDING <br /> H y I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> 8 C Driving range, clubhouse APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> C) My LEGAL DEscRIPTroN Or PROPERrYlslow neww on Aneunoun coPlEsl CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> A Portion of Sec. 11, 2 T.28N GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> t1 LOT_BLOCK _Of— WHETHER WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br /> y y0 y R.4E.,W.M. The Ely iHQ' of tracts 1,8,9,16 of PERMIT VIOLATE OR SNOT PRESUME TO GIVE CAN EL THE PROVISIONS OF ANY <br /> AUTHORITY <br /> OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br /> Beverly Barry Tracts Div 2 THE PERFORMANCE OF CONSTRUCTION. <br /> JOB ADDRESS SIGNATURE iCONTRACTOR.RUTH 0AGENT.OR OWNER DAT <br /> 1215 80th St. SW X iS <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET)TOILET) AC-A-HNDLG UNITS--H P <br /> BATHTUB REFRIGERATION UNITS- H P EA <br /> LAVATORY(WASH BASIN) BOILERS-B T U M P <br /> SHOWER GAS FIRED A C UNITS-R T U <br /> KITCHEN SINK A DISH FORCED AIR SYSTEMS-0 T U M EA - <br /> DISHWASHER WALL HEATERS-O T U <br /> LAUNDRY TRAY UNIT HEATERS-B T U <br /> CaCLOTHES WASHER EVAPORATNE COOLERS <br /> URINAL CLOTHES DRYERS <br /> I I DRINKING FOUNTAIN VENTILATION FAN <br /> `_ FLOOR DRAIN RANGE HOOD <br /> BACKFLOW PREVENTERS WATER HEATER 000921247 <br /> ROOF DRAINS-RAINLEADERS WOOD STUVE <br /> SINK(SERVICE-BAR.ETC) METAL FIREPLACE 8 CIIIMN <br /> FIREPLACE INSERT <br /> ' HEAT PUMP <br /> GAS PIPING `' <br /> 46 <br /> EXHAUST FAN <br /> 1 SUBTOTAL { BUB <br /> PERMIT S PERM <br /> TOTALFEE 3 TOTA <br /> 4IONT SETBACK HEAR SETBACK SIDE St DUCK PLAN CHECK NUMBER FEE RECEIPT NO <br /> � <br /> 150' 1000' 506240' 88/21246 454.35 14381 <br /> AAS USE20NE IDT ALFA VACANT SITE <br /> M-M 807,757 kj'ES LINO FEES VALUATION FEE <br /> TYPE OF CONST o"CMANC,GROUP NO O,nwn LING UNI).; BUILDING $134,400.00 76 <br /> V-N B-2 O PLUMBING <br /> -4E OF elm NO n11InRIl, MA. Or IOAD <br /> 4800 1 145 MECHANICAL <br /> INVESTIGATION FEE Plan k SD` 304101 4C 95 <br /> FIRE SPRINKLERS REOUIRED M YES NO STATE BUILDING SURCHARGE , <br /> 50 <br /> STATE ENERGY SURCHARGE 151 00 <br /> /.PPLICATION ACC RY 1`I ANS CII CLOD IIv ,"m I'M ISBUANCE fly <br /> DRIVEWAY PERMIT <br /> S.H. B.E. B.E. TOTAL 82 45 <br /> PERMIT VALIDATION <br /> WHEN PROPERLY VALIDATED TIN THIS SPACE)T141S 15 YOUR PERMIT CJD <br /> d- <br /> N <br /> a— <br /> N <br /> A:I ,11 .. <br />